Blood compatibility of SPUU-PEO-heparin graft copolymers

Refining of Particulates at Stimuli-Responsive Interfaces: Label-Free Sorting and Isolation

The mechanism of separation methods, for example, liquid chromatography, is realized through rapid multiple adsorption-desorption steps leading to the dynamic equilibrium state in a mixture of molecules with different partition coefficients. Sorting of colloidal particles, including protein complexes, cells, and viruses, is limited due to a high energy barrier, up to millions kT, required to detach particles from the interface, which is in dramatic contrast to a few kT for small molecules. Such a strong interaction renders particle adsorption quasi-irreversible. The dynamic adsorption-desorption equilibrium is approached very slowly, if ever attainable. This limitation is alleviated with a local oscillating repulsive mechanical force generated at the microstructured stimuli-responsive polymer interface to switch between adsorption and mechanical-force-facilitated desorption of the particles. Such a dynamic regime enables the separation of colloidal mixtures based on the particle-polymer interface affinity, and it could find use in research, diagnostics, and industrial-scale label-free sorting of highly asymmetric mixtures of colloids and cells.

Sung Wan Kim - Early events in blood/material interactions

Sung Wan Kim's initial efforts as an independent investigator were focused on improving the understanding of the early events in blood/material interactions with the goal to develop blood compatible materials for application in medical devices and prostheses. These initial efforts were centered around blood protein adsorption on biomaterials and related mechanisms of thrombus formation (thrombosis). Ultimately, Sung Wan's efforts were expanded to studies of the non-thrombogenic nature of heparinized biomaterials, prostaglandin biomaterials, and block copolymer systems. These studies were supported by two NIH grants for 22 and 19 years, respectively, and a NIH Career Development Award. Moreover, these studies resulted in over 140 peer-reviewed publications and training of many students and postdoctoral scientists. The intent of this paper is to identify key concepts, papers, and contributions by Sung Wan and his colleagues that fall within the four aforementioned research categories. In this context, many of Sung Wan's early efforts contributed directly to Utah's biomaterials efforts and the Total Artificial Heart program at the time, while providing the foundation for the productive international Triangle Collaboration as well as his following work in polymer-controlled drug releasing systems.

Nanostructured Surfaces That Mimic the Vascular Endothelial Glycocalyx Reduce Blood Protein Adsorption and Prevent Fibrin Network Formation

Blood-contacting materials are critical in many applications where long-term performance is desired. However, there are currently no engineered materials used in cardiovascular implants and devices that completely prevent clotting when in long-term contact with whole blood. The most common approach to developing next-generation blood-compatible materials is to design surface chemistries and structures that reduce or eliminate protein adsorption to prevent blood clotting. This work proposes a new paradigm for controlling protein-surface interactions by strategically mimicking key features of the glycocalyx lining the interior surfaces of blood vessels: negatively charged glycosaminoglycans organized into a polymer brush with nanoscale domains. The interactions of two important proteins from blood (albumin and fibrinogen) with these new glycocalyx mimics are revealed in detail using surface plasmon resonance and single-molecule microscopy. Surface plasmon resonance shows that these blood proteins interact reversibly with the glycocalyx mimics, but have no irreversible adsorption above the limit of detection. Single-molecule microscopy is used to compare albumin and fibrinogen interactions on surfaces with and without glycocalyx-mimetic nanostructures. Microscopy videos reveal a new mechanism whereby the glycocalyx-mimetic nanostructures eliminate the formation of fibrin networks on the surfaces. This approach shows for the first time that the nanoscale structure and organization of glycosaminoglycans in the glycocalyx are essential to (i) reduce protein adsorption, (ii) reversibly bind fibrin(ogen), and (iii) inhibit fibrin network formation on surfaces. The insights gained from this work suggest new design principles for blood-compatible surfaces. New surfaces developed using these design principles could reduce risk of catastrophic failures of blood-contacting medical devices.

Glycocalyx-Inspired Nitric Oxide-Releasing Surfaces Reduce Platelet Adhesion and Activation on Titanium

The endothelial glycocalyx lining the inside surfaces of blood vessels has multiple features that prevent inflammation, blood clot formation, and infection. This surface represents the highest standard in blood compatibility for long-term contact with blood under physiological flow rates. Engineering materials used in blood-contacting biomedical devices, including metals and polymers, have undesirable interactions with blood that lead to failure modes associated with inflammation, blood clotting, and infection. Platelet adhesion and activation are key events governing these undesirable interactions. In this work, we propose a new surface modification to titanium with three features inspired by the endothelial glcyocalyx: First, titanium surfaces are anodized to produce titania nanotubes with high surface area. Second, the nanostructured surfaces are coated with heparin-chitosan polyelectrolyte multilayers to provide glycosaminoglycan functionalization. Third, chitosan is modified with a nitric oxide-donor chemistry to provide an important antithrombotic small-molecule signal. We show that these surfaces are nontoxic with respect to platelets and leukocytes. The combination of glycocalyx-inspired features results in a dramatic reduction of platelet and leukocyte adhesion and platelet activation.

Synthesis and Evaluation of Heparinized Biocompatible Materials Using Heparin/Surface-Active Compound Complexes

Heparin, an antithrombogenic mucopolysaccharide, forms com plexes with lecithin and other surface-active compounds (SAC). The complexes are soluble in organic solvents. The heparin/SAC complexes have antithrombo genic activity similar to heparin. Heparinized materials, in which the heparin/SAC complexes were used, showed an excellent in vitro nonthrombo genicity. The heparinized materials do not influence in vitro cell growth and showed an excellent biocompatibility.

Immobilization of an antithrombin-heparin complex on gold: anticoagulant properties and platelet interactions

The anticoagulant properties and platelet interactions of gold surfaces modified with an antithrombin-heparin (ATH) complex are reported. ATH was attached to gold through either a short disulfide (linker) or a thiol-terminated polyethylene oxide (PEO) (linker, spacer). Analogous surfaces were prepared with uncomplexed heparin. Antithrombin (AT) uptake was measured before and after selectively destroying the active pentasaccharide sequence of the heparin moiety, and was found to be predominantly through the active sequence on all of the surfaces. AT binding was higher on the ATH surfaces than on the corresponding heparin surfaces. Heparin activity was assessed by an anti-factor Xa assay. The ratio of active heparin density (from the anti-FXa assay) to total heparin density was taken as a measure of heparin bioactivity. The ratio was greater on the ATH- than on the heparin-modified surfaces, i.e. the PEO-ATH surfaces showed the greater proportion of active heparin. Platelet adhesion from flowing whole blood was found to be reduced on PEO- and ATH-modified surfaces compared to bare gold. The PEO-ATH modified surfaces, but not the heparinized surfaces, were shown to prolong the clotting time of recalcified plasma.

Engineering nanoassemblies of polysaccharides

Polysaccharides offer a wealth of biochemical and biomechanical functionality that can be used to develop new biomaterials. In mammalian tissues, polysaccharides often exhibit a hierarchy of structure, which includes assembly at the nanometer length scale. Furthermore, their biochemical function is determined by their nanoscale organization. These biological nanostructures provide the inspiration for developing techniques to tune the assembly of polysaccharides at the nanoscale. These new polysaccharide nanostructures are being used for the stabilization and delivery of drugs, proteins, and genes, the engineering of cells and tissues, and as new platforms on which to study biochemistry. In biological systems polysaccharide nanostructures are assembled via bottom-up processes. Many biologically derived polysaccharides behave as polyelectrolytes, and their polyelectrolyte nature can be used to tune their bottom-up assembly. New techniques designed to tune the structure and composition of polysaccharides at the nanoscale are enabling researchers to study in detail the emergent biological properties that arise from the nanoassembly of these important biological macromolecules.

Plasma Protein Adsorption and Platelet Adhesion on Heparin-Immobilized Polyurethane Films

Polyurethane surfaces were modified by covalent immobilization of different molecular weight heparins (fractionated Mw ~3000 Da, and unfractionated Mw ~17,000—19,000 Da) and examined by ESCA, AFM, and contact angle goniometer. The effect of these different surface-immobilized heparins on blood protein adsorption and on platelet adhesion, were examined after incubating the samples with platelet-poor and platelet-rich plasma. Protein adsorption kinetics was studied by electrophoresis and the platelets adhered on the surfaces were examined by SEM after incubation. The two heparin types clearly showed different behavior with respect to protein adsorption, especially in the early stages of blood plasma interaction. After a 5-min incubation in plasma, low molecular weight heparin-immobilized polyurethanes (PU-LMWH) showed three times less protein adsorption compared to unfractionated heparin-immobilized polyurethanes (PU-UFH). The total amount of adhered protein became more similar as the incubation time was extended. The morphology of adhered platelets on material surfaces demonstrated differences: PU-UFH had clusters with some pseudopodia extensions, while PU-LMWH surfaces had round-shaped platelets with little clustering. For contact times >15 min, the amount of adsorbed proteins and adhered platelets on the heparinized PU surfaces decreased.

Preparation and Surface Modification of Poly(acrylonitrile-co-acrylic acid) Electrospun Nanofibrous Membranes

Poly(acrylonitrile-co-acrylic acid) (PANCAA) was synthesized and fabricated into nanofibrous membranes by an electrospinning technique. Scanning electron microscopy revealed that membranes composed of uniformly thin and smooth nanofibres were obtained under optimized processing parameters. Surface modification with chitosan on these nanofibrous membranes was accomplished by a coupling reaction between the carboxylic groups of PANCAA and the primary amino groups of chitosan. Fluorescent labelling, weight measurement, FT-IR/ATR spectroscopy, and X-ray photoelectron spectroscopy (XPS) were used to confirm the modification process and determine the immobilization degree of chitosan. Platelet adhesion experiments were further carried out to evaluate the hemocompatibility of the studied nanofibrous membranes. Preliminary results indicated that the immobilization of chitosan on the PANCAA nanofibrous membranes was favourable for platelet adhesion.

Influence of spacer length on heparin coupling efficiency and fibrinogen adsorption of modified titanium surfaces

Background

Chemical bonding of the drug onto surfaces by means of spacer molecules is accompanied with a reduction of the biological activity of the drug due to a constricted mobility since normally only short spacer molecule like aminopropyltrimethoxysilane (APMS) are used for drug coupling. This work aimed to study covalent attachment of heparin to titanium(oxide) surfaces by varying the length of the silane coupling agent, which should affect the biological potency of the drug due to a higher mobility with longer spacer chains.

Methods

Covalent attachment of heparin to titanium metal and TiO₂ powder was carried out using the coupling agents 3-(Trimethoxysilyl)-propylamine (APMS), N- [3-(Trimethoxysilyl)propyl]ethylenediamine (Diamino-APMS) and N¹- [3-(Trimethoxy-silyl)-propyl]diethylenetriamine (Triamino-APMS). The amount of bound coupling agent and heparin was quantified photometrically by the ninhydrin reaction and the tolidine-blue test. The biological potency of heparin was determined photometrically by the chromogenic substrate Chromozym TH and fibrinogen adsorption to the modified surfaces was researched using the QCM-D (Quartz Crystal Microbalance with Dissipation Monitoring) technique.

Results

Zeta-potential measurements confirmed the successful coupling reaction; the potential of the unmodified anatase surface (approx. -26 mV) shifted into the positive range (> + 40 mV) after silanisation. Binding of heparin results in a strongly negatively charged surface with zeta-potentials of approx. -39 mV. The retaining biological activity of heparin was highest for the spacer molecule Triamino-APMS. QCM-D measurements showed a lower viscosity for adsorbed fibrinogen films on heparinised surfaces by means of Triamino-APMS.

Conclusion

The remaining activity of heparin was found to be highest for the covalent attachment with Triamino-APMS as coupling agent due to the long chain of this spacer molecule and therefore the highest mobility of the drug. Furthermore, the adsorption of fibrinogen on the differently heparinised surfaces in real time demonstrated that with longer spacer chains the ΔD/Δf ratios became higher, which is also associated with better biocompatible properties of the substrates in contact with a biosystem.

Protein adsorption on polyurethane catheters modified with a novel antithrombin-heparin covalent complex

Highly anticoagulant covalent antithrombin-heparin complex (ATH) was covalently grafted onto polyurethane catheters to suppress adsorption/activation of procoagulant proteins and enhance adsorption/activation of anticoagulant proteins for blood compatibility. Consistency of catheter coating was demonstrated using immunohistochemical visualization of ATH. The ability of the resulting immobilized ATH heparin chains to bind antithrombin (AT) from plasma, as measured by binding of (125)I-radiolabeled AT, was greater than that for commercially-available heparin-coated catheters, and much greater than for uncoated catheters. Complementary measurements of antifactor Xa (FXa) activity and plasma protein binding were also performed. Both ATH-coated and heparin-coated catheters demonstrated functional binding of exogenous AT. However, the ATH-coated catheters gave a trend towards elevated anti- FXa activities/AT binding ratios, consistent with the higher active pentasaccharide content in starting ATH. Western blot analysis of proteins adsorbed to catheters after incubation with rabbit plasma established protein binding profiles that showed AT and albumin as major plasma proteins adsorbed to ATH-coated catheters, while AT and altered forms of fibrinogen were major plasma protein species adsorbed to heparinized catheters.

Immobilization of heparin on a silicone surface through a heterobifunctional PEG spacer

A novel method of immobilizing heparin on a silicone surface through a heterobifunctional PEG spacer was used yield well defined surfaces with highly active surface immobilized heparin and low non-specific protein adsorption. The heparin surface density achieved using this technique was 0.68 microg/cm2. Sessile drop water contact angles showed increased hydrophilicity of the silicone surface after PEG modification and a further decrease in the contact angles following the grafting of heparin. High specificity for ATIII with little fibrinogen adsorption was noted in plasma adsorption studies. This ATIII adsorption was mediated by the heparin layer, since surfaces modified with PEG only did not adsorb significant quantities of AT. The thrombin resistance of the heparin modified surfaces was demonstrably greater as measured by a chromogenic thrombin generation assay. The results suggest that the heterbifunctional PEG linker results in a high density of active heparin on the surfaces.

Preparation and characterization of polymeric coatings with combined nitric oxide release and immobilized active heparin

A new dual acting polymeric coating is described that combines nitric oxide (NO) release with surface-bound active heparin, with the aim of mimicking the nonthrombogenic properties of the endothelial cell (EC) layer that lines the inner wall of healthy blood vessels. A trilayer membrane configuration is employed to create the proposed blood compatible coating. A given polymeric substrate (e.g., the outer surface of a catheter sleeve, etc.) is first coated with a dense polymer layer, followed by a plasticized poly(vinyl chloride) (PVC) or polyurethane (PU) layer doped with a lipophilic N-diazeniumdiolate as the NO donor species. Finally, an outer aminated polymer layer is applied. Porcine heparin is then covalently linked to the outer layer via formation of amide bonds. The surface-bound heparin is shown to possess anti-coagulant activity in the range of 4.80-6.39 mIU/cm2 as determined by a chromogenic anti-Factor Xa assay. Further, the surface NO flux from the underlying polymer layer containing the diazeniumdiolate species can be controlled and maintained at various levels (from 0.5 to 60 x 10(-10) mol cm(-2)min(-1)) for at least 24 h and up to 1 week (depending on the flux level desired) by changing the chemical/polymer composition of the NO release layer. The proposed polymeric coatings are capable of functioning by two complementary anti-thrombotic mechanisms, one based on the potent anti-platelet activity of NO, and the other the result of the ability of immobilized heparin to inhibit Factor Xa and thrombin (Factor IIa). Thus, the proposed polymeric coatings are expected to exhibit greatly enhanced thromboresistivity compared to polymers that utilize either immobilized heparin or NO release alone.

Hemocompatibility and anaphylatoxin formation of protein-immobilizing polyacrylonitrile hemodialysis membrane

Plasma proteins were covalently immobilized onto polyacrylonitrile (PAN) membrane to evaluate the hemocompatibility and anaphylatoxin formation. This is used as a model to study the effect of protein-adsorption on the blood-contacting response of hemodializing membranes. The proteins used were either platelet-adhesion-promoting collagen (COL) or platelet-adhesion-inhibiting human serum albumin (HSA). The microstructure and characterization of the protein-immobilizing PAN membranes were evaluated by Coomassie dye assay, atomic force microscopy, X-ray photoelectron spectroscopy and water contact angle measurement. PAN-HSA membrane improved not only hemocompatibility including less platelet adhesion, longer blood coagulation times, and higher thrombin inactivity level, but also induced lower complement activation. On the other hand, PAN-COL membrane exhibited blood incompatibility, although induced less increase of C3, C4 antigens of serum. Overall results of this study demonstrated that the immobilization of HSA onto the surface of PAN membrane would be beneficial to improve the hemocompatibility and to reduce the anaphylatoxin formation during hemodialysis.

Investigation of recombinant human elastin polypeptides as non-thrombogenic coatings

We investigated the use of a recombinant human elastin polypeptide as a coating on synthetic materials with a view to determining if these polypeptides could improve the blood compatibility of cardiovascular devices such as vascular conduits and arterial/venous catheters. Platelet adhesion and activation were studied in vitro using three commercially available synthetic materials: polyethylene terephthalate (Mylar), a poly(tetrafluoroethylene/ethylene) copolymer (Tefzel) and a polycarbonate polyurethane (Corethane). Coated with adsorbed polypeptide, all three synthetic materials demonstrated reduced platelet activation and adhesion in platelet rich plasma in vitro. Compared to non-coated controls, there was a significant decrease (p=0.05) in both platelet microparticle release and P-selectin expression for the polypeptide-coated surfaces. Scanning electron microscopy indicated fewer adhering platelets on coated surfaces compared to non-coated controls. In vivo, in a rabbit model, evaluations of polyurethane catheters coated with the polypeptide showed a marked increase in catheter patency and a significant decrease in fibrin accretion and embolism when compared to uncoated controls. This polypeptide shows a strong potential for use as a non-thrombogenic coating for small diameter vascular grafts. In addition, the results of this study indicate that the elastin polypeptide would be a valuable component of a tissue engineered vascular conduit.

Hemocompatibility of polyacrylonitrile dialysis membrane immobilized with chitosan and heparin conjugate

Chitosan (CS)/heparin (HEP) polyelectrolyte complex (PEC) was covalently immobilized onto the surface of polyacrylonitrile (PAN) membrane. The effect of surface modification on the protein adsorption and platelet adhesion, metabolites permeation and anticoagulation activity of the resulting membrane was investigated. Surface characterization such as water contact angle, and X-ray photoelectron spectroscope were performed. The immobilization of PEC caused the water contact angle to reduce, thereby indicating the increase in the hydrophilicity. Protein adsorption, platelet adhesion, and thrombus formation were all reduced by the immobilization of HEP. Anticoagulant activity was evaluated with activated partial thrombin time (APTT), prothrombin time (PT), fibrinogen time, and thrombin time (TT). The results revealed that PEC-immobilizing membrane can improve antithrombogenicity of PAN membrane. In addition, the PEC-immobilized membranes can suppress the proliferation of Pseudomonas aeruginosa. In vitro cytotoxicity test showed leachable substance released was below cytotoxic level. The pure water permeability results show little variation due to PEC-immobilization. Thus PEC-immobilization can endow the PAN membrane hemocompatibility and antibacterial activity while retaining the original permeability.

PEO-like plasma polymerized tetraglyme surface interactions with leukocytes and proteins: in vitro and in vivo studies

Polyethylene oxide (PEO) surfaces reduce non-specific protein and cell interactions with implanted biomaterials and may improve their biocompatibility. PEO-like polymerized tetraglyme surfaces were made by glow discharge plasma deposition onto fluorinated ethylene propylene copolymer (FEP) substrates and were shown to adsorb less than 10 ng/cm2 of fibrinogen in vitro. The ability of the polymerized tetraglyme surfaces to resist leukocyte adhesion was studied in vitro and in vivo. Polymerized tetraglyme and FEP were implanted subcutaneously in mice and removed after 1 day or 4 weeks. Histological analysis showed a similar degree of fibrous encapsulation around all of the 4-week implants. Darkly stained wells were present in the fibrous tissues at the tissue-material interface of both FEP and tetraglyme. Scanning electron micrographs showed that in vivo macrophage adhesion to polymerized tetraglyme was much higher than to FEP. After 2-hour contact with heparinized whole blood, polymorphonuclear leukocyte (PMN) adhesion to polymerized tetraglyme was much higher than to FEP, while platelet adhesion to polymerized tetraglyme was lower than to FEP. When PMNs isolated from blood were suspended in 10% autologous plasma, cell adhesion to polymerized tetraglyme was higher than to FEP; however when the cells were suspended in heat inactivated serum, cell adhesion to FEP was higher than to polymerized tetraglyme. The surface chemistry of polymerized tetraglyme did not change after 2-hour blood contact, but displayed nitrogen functional groups after 1-day implantation and became slightly degraded after 4-week implantation. The surface chemistry of FEP did not change significantly after blood contact or implantation. Loosely bound proteins such as fibrinogen on polymerized tetraglyme may contribute to the adhesion of PMNs and macrophages and ultimately to fibrous encapsulation (the foreign body response) around the implants.

Importance of a biofouling-resistant phospholipid polymer to create a heparinized blood-compatible surface

Heparinization is believed to be one of the methods to suppress thrombus formation on blood-contacting surfaces. However, this study hypothesizes that heparinization alone might not be sufficient to provide a blood-compatible surface; that is, a surface property that resists biofouling is necessary to obtain an effective heparin-modified surface. 2-Methacryloyloxyethyl phosphorylcholine (MPC) polymers with 2-aminoethyl methacrylate (AEMA) were synthesized to immobilize heparin through ionic bonding. The primary amino groups of AEMA were considered to be the polymer surface because the zeta-potential of the surface was positive when the mole fraction of the AEMA units was above 0.2. The antithrombogenic character of the polymer surface modified with heparin was evaluated by both Lee-White and microsphere column methods. The coagulation period of human whole blood in the absence of anticoagulant in glass tubing coated with the MPC polymer was longer than that in the original glass tube. Cell adhesion was completely inhibited on the MPC polymer surface after contact with human whole blood without anticoagulant. However, many adherent blood cells were observed on poly(2-ethylhexyl methacrylate-co-AEMA) (no MPC unit) even after heparinization. These results strongly indicate that the MPC polymer is a useful substrate where the heparin works well and that the heparin-immobilized MPC polymer has superior blood compatibility to the simple MPC polymer.

Nanoscale clustering of RGD peptides at surfaces using Comb polymers. 1. Synthesis and characterization of Comb thin films

Theoretical and experimental studies were conducted to elucidate the structure and properties of amphiphilic comb polymer thin films presenting nanoscale clusters of Arg-Gly-Asp (RGD) peptides for control of cell adhesion on biomaterials. Combs comprised of a poly(methyl methacrylate) backbone and short poly(ethylene oxide) side chains were synthesized, and peptides were tethered to the side chain ends to create nanoscale peptide clusters. In thin films, comb polymers containing >or = 30 wt % six to nine unit PEO side chains completely resisted adhesion of a model fibroblast cell line in the presence of 7.5% serum over 24 h. These same polymers modified with RGD peptides elicited tunable cell adhesion when mixed with unmodified combs in varying proportion. A self-consistent field lattice model of the interface between comb polymer films and water predicts an organization of the top molecular layer of comb polymer with the backbone oriented parallel to the interface in quasi-two-dimensional confinement and hydrophilic side chains extended in a brushlike layer into solution. This picture of a quasi-2D configuration is consistent with the observed surface properties of comb films in water as well as measurements of the RGD cluster density on mixed comb surfaces using fluorescent nanosphere labeling of ligand clusters.

Anticoagulant activity of immobilized heparin on the polypropylene nonwoven fabric surface depending upon the pH of processing environment

Antenna coupling microwave plasma enables a highly oxidative treatment of the outmost surface of polypropylene (PP) nonwoven fabric within a short time period. Subsequently, grafting copolymerization with acrylic acid (AAc) makes the plasma-treated fabric durably hydrophilic and excellent in water absorbency. With high grafting density and strong water affinity, the pAAc-grafted support greatly becomes feasible as an intensive absorbent and as a support to promote heparin immobilization through amide bonds. For heparin immobilized in acidic condition, the carbonate groups of the molecule tend to dissolve and passive encapsulation of the molecule prevents its functional groups from bonding with the carboxylic acid of pAAc. This effect leads to inhibit the immobilization process and consequently reduces the quantity as well as the bioactivity of the immobilized heparin. In alkaline processing environment, the oxidized uronic acid residues in heparin-related glycans are presumably cleaved and the removal of some oxidized residuals before immobilization process is likely to reduce the chain length of heparin. In the latter case, anticoagulant Factors X and XII, but not thrombin, are unaffected. Anticoagulant activity test using activated partial thromboplastin time (aPTT) is more sensitive in assessing heparin-immobilized surfaces, since it corresponds to Factor X and initiates the inhibition of Factor XII and thrombin. Likewise, platelets adhesion on the surfaces decreases as the process shifted from acidic to alkaline condition, whereas the hydrophilic character of the grafted pAAc markedly contributes to extend physical insertion of platelets. The immobilized heparin has a great part of original bioactivity, depending on the pH of the processing environment and the immobilized quantity. Relative bioactivity based upon aPTT tests is partially held longer than 90 days for the sample prepared in the alkaline or neutral environment.

Immobilization of a nonsteroidal antiinflammatory drug onto commercial segmented polyurethane surface to improve haemocompatibility properties

A method has been developed in which a layer of p-aminosalicylic acid (4-amino-2-hydroxybenzoic acid) (PAS), a water soluble pharmaceutical compound of the nonsteroidal anti-inflammatory drug (NSAID) class with antiaggregant platelet activity, is covalently immobilized onto a segmented polyurethane, Biospan (SPU) surface. Thus, SPU surfaces were modified by grafting of hexamethylenediisocyanate. and the free isocyanate remaining on the SPU surface were then coupled through a condensation reaction to amine groups of p-aminosalicylic acid. The bonding of PAS from aqueous solution onto SPU surface was studied by ATR-FTIR. UV and fluorescence spectroscopy. Plateau levels of coupled PAS were reached within 1.2 microg/cm2 using PAS solution concentrations of 1mg/ ml. The surface wettability of the polymeric films measured by contact angle indicate that the introduction of the PAS turns the surface more hydrophilic (theta(water) = 43.1 +/- 2.1) relatively to the original SPU films (theta(water) = 70.3 +/- 1.9). The in vitro albumin (BSA) adsorption shows that the PAS-SPU films adsorb more BSA (250/microgmm2) than the original SPU (112 microg mm2). Thrombogenicity was assessed by measuring the thrombus formation and platelet adhesion of the SPU containing PAS relatively to nonmodified SPU surfaces. The polymeric surfaces with immobilized PAS had better nonthrombogenic characteristics as indicated by the low platelet adhesion, high adsorption of albumin relatively to fibrinogen and low thrombus formation, making them potentially good candidates for biomedical applications.

In vitro study of blood-contacting properties and effect on bacterial adhesion of a polymeric surface with immobilized heparin and sulphated hyaluronic acid

The blood-contacting properties and the effect on bacterial adhesion of a material based on polyurethane and poly(amido-amine) (PUPA), both in its native form and with the anticoagulant molecules heparin or sulphated hyaluronic acid (HyalS3.5) electrostatically bonded to its surface, were evaluated and compared in vitro. The presence of the biological molecules on the surface was revealed by a dye test and ATR/FTIR analysis. Bound heparin was found to maintain its physiological action, in terms of thrombin inactivation, as well as did free heparin. Moreover, it reduced the degree of platelet adhesion. On the contrary, bound HyalS3.5 lost its anticoagulant activity, though it reduced platelet adhesion. The number of platelets on both modified surfaces was low. Their shape distribution, as determined by SEM, did not differ significantly on the two modified surfaces or with respect to the bare PUPA surface. HyalS3.5 and heparin also inhibited adhesion of Staphylococcus epidermidis to the material. A possible relationship between the platelet and bacterial adhesion is ascribed to the mediating role of plasma proteins.

Heparinized bovine pericardium as a novel cardiovascular bioprosthesis

A novel chemical modification of biological tissues was developed by the direct coupling heparin to bovine pericardium (BP). The heparinization involves pretreatment of BP using GA and followed by grafting heparin to BP by the reaction of residual aldehyde and amine group of heparin. BP was modified by direct coupling of heparin and the effect of heparin coupling on calcification was evaluated in vitro and in vivo. Heparinized BP was characterized by measuring shrinkage temperature, mechanical properties, digestion resistance to collagenase enzyme, in vitro cytotoxicity, and in vivo calcification. Thermal and mechanical properties showed that the durability of heparin-treated tissue increased as compared with fresh tissue and GA-treated tissue. Resistance to collagenase digestion revealed that heparin-treated tissue has greater resistance to enzyme digestion than did fresh tissue and GA-treated tissue. Heparinized tissue had shown to be non-cytotoxic, however, relatively high cytotoxicity was observed in the GA-treated tissues due to the release of GA. In vivo calcification study demonstrated much less calcium deposition on heparin-treated BP than GA-treated one. Obtained results attest to the usefulness of heparinized BP for cardiovascular bioprostheses.

Polymer latexes for cell-resistant and cell-interactive surfaces

Novel polymer latexes were prepared that can be applied in several ways for the control and study of cell behavior on surfaces. Acrylic latexes with glass transitions ranging from -30 to 100 degrees C were synthesized by dispersion polymerization in a water and alcohol solution using an amphiphilic comb copolymer as a stabilizing agent. The comb had a poly(methyl methacrylate) backbone and hydrophilic poly(ethylene glycol) (PEG) side chains, which served to stabilize the dispersion and create a robust hydrophilic coating on the final latex particles. The end groups of the comb stabilizer can be selectively functionalized to obtain latex particles with a controlled density of ligands tethered to their surfaces. Latexes were prepared with adhesion peptides (RGD) linked to the surface of the acrylic beads to induce attachment and spreading of cells. Coalesced films obtained from the RGD-bearing latex particles promoted attachment of WT NR6 fibroblasts, while films from unmodified latex particles were resistant to these cells. Additionally, RGD-linked beads were embedded in cell-resistant comb polymer films to create cell-interactive surfaces with discrete clustered-ligand domains. Cell attachment and morphology were seen to vary with the surface density of the RGD-bearing latex beads.

Surface characteristics and biocompatibility of lactide-based poly(ethylene glycol) scaffolds for tissue engineering

Novel lactide-based poly(ethylene glycol) (PEG) polymer networks (GL9-PEGs) were prepared by UV copolymerization of a glycerol-lactide triacrylate (GL9-Ac) with PEG monoacrylate (PEG-Ac) to use as scaffolds in tissue engineering, and the surface properties and biocompatibility of these networks were investigated as a function of PEG molecular weight and content. Analysis by ATR-FTIR and ESCA revealed that PEG was incorporated well within the GL9-PEG polymer networks and was enriched at the surfaces. From the results of SEM, AFM, and contact angle analyses, GL9-PEG networks showed relatively rough and irregular surfaces compared to GL9 network, but the mobile PEG chains coupled at their termini were readily exposed toward the aqueous environment when contacting water such that the surfaces became smoother and more hydrophilic. This reorientation and increase in hydrophilicity were more extensive with increasing PEG molecular weight and content. As compared to GL9 network lacking PEG, protein adsorption as well as platelet and S. epidermidis adhesion to GL9-PEG networks were significantly reduced as the molecular weight and content of PEG was increased, indicating that GL9-PEG networks are more biocompatible than the GL9 network due to PEG's passivity. Based on the physical and biological characterization reported, the GL9-PEG materials would appear to be interesting candidates as matrices for tissue engineering.

Sulfonated poly(ethylene oxide)-grafted polyurethane copolymer for biomedical applications

Sulfonated poly(ethylene oxide) (PEO-SO3)-grafted polyurethane (PU) copolymer (PU-PEO-SO3) was developed for utilization as a material for biomedical applications. Its bulk properties and biocompatibility were investigated and the results were compared to those of PU and PU-PEO (not sulfonated). PU-PEO-SO3 copolymer showed higher water uptake than PU and PU-PEO, indicative of increased hydrophilicity due to the grafting of PEO-SO3. Compared with PU, PU-PEO-SO3 displayed lower glass transition temperature (Tg) and melting endotherm from DSC analysis, suggesting the increase of microphase separation and the suppression of hard-segment packing. PU-PEO-SO3 had practically similar mechanical properties to PU, indicating that the chemical modification of PU was accomplished without reducing its bulk properties. From the results of biocompatibility tests, PU-PEO-SO3 copolymer showed significantly lower adhesion of platelets and S. epidermidis than PU control and PU-PEO. In addition, the platelet factor 4 (PF4) released from platelets was the lowest in PU-PEO-SO3 among the test materials. PU-PEO-SO3 copolymer, which has excellent mechanical properties and biocompatibility, is expected to be useful as coating, molding, and blending materials for artificial organs and medical devices.

Preparation and characterization of heparin-containing SBS-g-DMAEMA copolymer membrane

The grafting of dimethyl amino ethyl methacrylate (DMAEMA) onto styrene-butadiene-styrene triblock copolymer (SBS) membrane was subsequently conducted by UV-radiation induced graft copolymerization without degassing to obtain the SBS-g-DMAEMA copolymer membrane. The substituted amino groups on the SBS-g-DMAEMA graft copolymer membrane were quaternized with iodomethane, and then the membrane was treated with heparin to prepare the heparin-containing SBS-g-DMAEMA copolymer membrane (SBS-g-DMAEMA-HEP). The graft copolymer membrane (SBS-g-DMAEMA) and the heparin-containing SBS-g-DMAEMA copolymer membrane (SBS-g-DMAEMA-HEP) were characterized by FTIR spectroscopy. The heparin content was determined by toluidine blue heparin assay. Contact angle, water content, and protein adsorption of fibrinogen and albumin experiments were also performed to evaluate the effect of graft amount and heparin content on the biocompatibility of SBS-g-DMAEMA and SBS-g-DMAEMA-HEP graft copolymer membranes. By using Kaelble's equation, the surface tension of SBS-g-DMAEMA and SBS-g-DMAEMA-HEP were determined. It was found that with increasing grafting amount and the heparin content, the surface tension and water content of SBS-g-DMAEMA membrane increased, whereas the contact angle decreased. The amount of the adsorption of albumin and fibrinogen decreased with increasing graft amount and heparin content. However, there was a minimum for adsorption of proteins in the SBS-g-DMAEMA and SBS-g-DMAEMA-HEP membranes.

Blood compatible phospholipid-containing polyurethanes: synthesis characterization and blood compatibility evaluation

A new diol, bis[2-(2-hydroxyethyldimethylammonio)ethyl] butylenediphosphate, that contains two phosphatidylcholine analogous moieties in one diol molecule, was synthesized and characterized. The diol together with 1,4-butanediol as chain extender was further incorporated into the propolymer of poly(ethylene oxide) (Mn = 1000, 2000, 6000) and 4,4'-methylenediphenyl diisocyanate. The resulting phospholipid poly(ether urethane)s show viscosity behavior of common polyelectrolytes. The bulk and surface characteristics of the new phospholipid poly(ether urethane)s were investigated by IR, GPC, ATR-FTIR, ESCA and contact angle measurements. The new polymers possessed relatively hydrophilic surface revealed by contact angle measurements. The blood compatibilities of the polyurethanes were evaluated by platelet rich plasma contacting studies and scanning electron microscopy observation using medical grade PVC as the reference. No platelet adhesion was observed for all new phospholipid polyurethane casting films. This new type of phospholipid polyurethane is expected to have potential biomedical applications.

Physicochemical properties and platelet interactions of segmented polyurethanes containing sulfonate groups in the hard segment

The adhesion of platelets to a series of segmented polyurethanes having sulfonate groups in the hard segment is reported. The polyurethanes were synthesized using sulfonated chain extenders of different structure. Analogous control materials without sulfonate groups also were studied. Adhesion was measured in vitro using washed human platelets in a carrier fluid consisting of Tyrode's buffer with apyrase, albumin, and red cells at normal concentration. The polymers were characterized by gel permeation chromatography and elemental analysis. Water absorption and thermal transitions also were determined. It was found that the sulfonated materials absorb significant amounts of water while the nonsulfonated analogs do not. The surfaces of polymer films were characterized by water contact angle and XPS. The contact angles of the sulfonated surfaces were relatively low. Platelet adhesion to the sulfonated polymers was found to be very high compared to the nonsulfonate analogs. The local environment of the sulfonate groups (different chain extenders) also appears to have an effect on platelet interactions. Albumin adsorption was high on all the materials and was not correlated with platelet adhesion. It appears from this work that platelets may have a binding site that is specific for sulfonate groups.

Biocompatibility of sulphonated polyurethane surfaces

Surfaces of medical devices made of polymeric materials may promote thrombosis and inflammation. Therefore, in an attempt to produce surfaces which might diminish biomaterial-mediated thrombosis and inflammation, surface derivatization with 2-acrylamido-2-methylpropanesulphonic acid (AMPS) was carried out. The derivatization procedure generates free radicals which initiate the copolymerization of AMPS monomers directly to a polyurethane surface. In an in vitro blood loop study using non-anticoagulated human blood, the resulting AMPS-derivatized material completely abrogates the generation of fibrinopeptide A, decreases the production of beta-thromboglobulin and C3a, and decreases the adherence of platelets. The derivatized material also attracts fewer adherent neutrophils when implanted in mice. However, AMPS derivatization unexpectedly increases the recruitment of macrophages to implanted material and promotes the formation of adherent sleeve thrombi on central venous catheters indwelling in non-anticoagulated canine femoral veins. Thus, AMPS derivatization has highly variable effects on inflammatory and thrombotic systems. Further investigation is clearly required to determine the mechanisms underlying both desired and adverse effects.

Small caliber vascular grafts. Part II: Polyurethanes revisited

Polyurethanes are considered to be one of the most bio- and blood-compatible biomaterials known today. By intelligent utilization of principles governing the structure/property relationship of these polymers, one can generate systems which resemble, in principle, the physical-mechanical behavior of living tissue. Thus, it is not surprising that these materials played a major role in development of small caliber vascular grafts targeted for vascular access, peripheral and coronary artery bypass indications. Numerous technologies, often esoteric in nature, were and are utilized to generate porous, potentially multilayered conduits possessing some or many characteristics of natural blood vessels. Properties such as durability, elasticity, compliance, pulsatility, and propensity for healing became attainable via polyurethanes. Furthermore, additional surface and/or bulk modification via attachments of biologically active species such as anticoagulants, cell proliferation suppressants, anti-infective compounds or biorecognizable groups are possible due to reactive groups which are part of the polyurethane structure. These modifications are designed to control or mediate host acceptance and healing of the graft. Finally, a myriad of practical processing technologies are used to fabricate functional grafts. Among those, casting, electrostatic and wet spinning of fibers and monofilaments, extrusion, dip coating or spraying of mandrels with polymer/additive solutions are often coupled with chemical-potential-difference-driven coagulation and phase inversion leading to grafts feeling and often behaving like natural vessels. Historically, the first polyurethanes utilized were hydrolytically unstable polyester polyurethanes containing hydrolysis-prone polyester polyols as soft segments, followed by hydrolytically stable but oxidation sensitive polyether polyols based polyurethanes. Polyether-based polyurethanes and their clones containing silicone and other modifying polymeric intermediates represented significant progress. Many viable technologies were discovered and developed using polyether-based polyurethanes. Chronic in vivo instability observed on prolonged implantation became, however, a major roadblock. The path led finally to the use of hydrolytically and oxidatively stable polycarbonate polyols as the soft segment to generate biodurable materials with resistance to biodegradation adequate for vascular access or perhaps peripheral graft indications. This biodurability needs to be further increased in order to utilize the full potential of polyurethanes in development of patent small caliber graft. Modification of both the soft and hard segments needs to be considered in order to maximize biodurability of both basic building blocks of the polyurethane. This paper reviews the achievements, discusses trends, and offers the view of the future in this exciting area of material/device combination.

Preparation and surface characterization of functional group-grafted and heparin-immobilized polyurethanes by plasma glow discharge

Functional group-grafted polyurethanes were prepared by oxygen plasma discharge treatment, followed by graft polymerization of 1-acryloylbenzotriazole (AB) and a subsequent substitution reaction of AB with sodium hydroxide and ethylene diamine. The primary amine or carboxylic acid groups grafted on the surfaces were coupled with heparin using water-soluble carbodiimide. The modified surfaces were characterized by measuring the water contact angle, electron spectroscopy for chemical analysis and attenuated total reflection Fourier-transform infrared spectroscopy. The amount of heparin covalently immobilized on the primary amine- and carboxylic acid group-grafted polyurethanes were 2.0 and 1.4 micrograms cm-2, respectively, as determined by the toluidine blue method. The water contact angle of the polyurethanes was decreased by AB grafting, and further decreased by the introduction of functional groups such as carboxylic acid and primary amine and immobilization of heparin, showing increased hydrophilicity of the modified surfaces. Heparin was almost not released from the immobilized surfaces in the physiological solution for 100 h, indicating good stability of immobilized heparin.

Antithrombogenicity of hydrophilic polyurethane-hydrophobic polystyrene IPNs. II. In vitro and ex vivo studies

To investigate the effect of hydrophilic and hydrophobic surfaces with phase separated structure on their blood responses, interpenetrating polymer networks (IPNs) composed of hydrophilic polyurethane (PU) and hydrophobic polystyrene (PS) were prepared by simultaneous polymerization. In vitro protein adsorption, in vitro platelet adhesion, and ex vivo A-A shunt test were carried out to evaluate the blood compatibility of the PU/PS IPNs. The results of protein adsorption on the PU/PS IPN surfaces indicated that albumin preferentially adsorbed on the hydrophilic surface (PU), while fibrinogen preferentially adsorbed on the hydrophobic surface (PS). The PU/PS IPNs exhibited suppressive properties for both platelet adhesion and activation. The occlusion time of U50S50 IPN containing 50 wt% of PS was twice as long as that of the PU control (50 min), indicating enhanced blood compatibility, presumably due to the selective adsorption of plasma proteins and the suppression of the adhesion and activation of platelets.

Heparin-coated cardiopulmonary bypass circuits

The indications for heparin-coated extracorporeal circuits cannot be defined or limited at present. Clinical investigation remains at an early stage of development. In situations where the risk of systemic anticoagulation is high, this technology would seem to hold great promise. Examples include extracorporeal lung assist and resuscitation from accidental hypothermia. Some have also suggested the use of heparin-coated circuits for percutaneous bypass in cardiopulmonary resuscitation. A significant advantage might also accrue in noncardiac surgical procedures requiring cardiopulmonary bypass, such as complex cerebral aneurysm or arteriovenous malformation resections, resections of the tracheal carina, or bilateral lung transplantations. Its role in routine cardiac surgical procedures remains uncertain, but the work of von Segesser et al suggests a need for continued investigation in that setting using reduced levels of systemic anticoagulation. That endeavor will be greatly assisted by the recent development of heparin-coated cardiotomy reservoirs. Although heparin-coated circuits have been safely used for extracorporeal lung assist with little or no systemic anticoagulation, prospective studies are clearly needed to determine if this approach is advantageous, and it would seem appropriate to develop heparin coating for silicone-based membrane oxygenators.